Clinicohematological Study of Pancytopenia in a Tertiary Care Hospital of Western Region of Nepal

Abstract

Introduction: Pancytopenia is a relatively common hematological entity and is a manifestation of many illnesses which can be life threatening at times. The severity of pancytopenia and the underlying pathology determine the management and prognosis. This study was conducted to evaluate hematological and bone marrow findings in patients presenting with pancytopenia.
 Methods: It was a prospective study carried out in Department of Pathology, Manipal College of Medical Sciences, Pokhara, Nepal, during the period of January 2011 to December 2016. Clinical and hematological parameters including bone marrow aspiration and biopsy were evaluated in all patients who presented with pancytopenia.
 Results: Among 138 cases studied, patient’s age ranged from 2 to 82 years with a mean age of 43.95 years, and there was male predominance. Most of the patients presented with generalized weakness, pallor, dypnoea and fever. Hypoplastic marrow was seen in 38(27.5%) cases, followed by megaloblastic anemia 26 (18.8%) cases and acute leukemia 19(13.76%) cases. Other findings included one each case of hemophagocyosis, leishmaniasis, plasmodium vivex malaria and metastatic carcinoma.
 Conclusions: This study highlights that pancytopenia is a common hematological problem and the study of detailed primary hematological investigations along with bone marrow study in patients with pancytopenia will help to identify the cause for further planning and management.
 Keywords: hypoplastic marrow; leukemia; megaloblastic anemia; pancytopenia.

Clinico-Hematological Study of Pancytopenia in Adults at a Tertiary Care Center

“…Ghartimagar et al found that patients' age ranged from 2 to 82 years with a mean age of 43.95 years, and there was male predominance. [5] Mansuri et al found that age of the patients ranged from 1 to 70 years with a slight male predominance. Most common age group was 11-20 years.…”

“…Ghartimagar et al found that most of the patients presented with generalized weakness, pallor, dypnoea and fever. [5] Mansuri et al found that most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly.…”

Pancytopenia: the perspective from Western Gujarat, India

“…In present study we had 2 patients of Rheumatoid arthritis 1 of scleroderma who were on immunosuppressant, Azathioprine presenting with pancytopenia.1pt of chronic myeloid leukemia on Imatinib, he recovered after withdrawal of drug and referred to haemato-oncologist for further management. 4 1989 France 213 Malignant myeloid and lymphoid disorders Varma et al 15 1992 India 203 Aplastic anemia Tilak et al 5 1999 India 77 Megaloblastic anemia Kumar et al 16 2001 India 166 Aplastic anemia Khunger et al 6 2002 India 200 Megaloblastic anemia Memon et al 17 2008 Pakistan 230 Aplastic anemia Jha et al 19 2008 Nepal 148 Hypoplastic marrow Santra G et al, Das Bk et al 18 2010 Calcutta, India 111 Aplastic anemia Jain Naniwadekar 14 2013 India 250 Hypersplenism Ridhi Agarwal et al 13 2015Meerut, India 70 Malaria Iqbal W et al 7 2001 Pakistan 208 Megaloblastic anemia Monika et al 10 2016 India 169 Megaloblastic anemia Ghartimagar et al 20 2017 Nepal 138 Hypoplasia of marrow All these patients7 (13%) underwent marrow analysis and were found to have hypocellular marrow as shown in (Table 5). Bone marrow biopsy analysis also helped to cirrhosis of liver portal hypertension splenomegaly did not undergo marrow analysis.…”

“…[15][16][17][18] Jha A et al, Ghartimagar D et al, reported Hypoplasia of marrow as the leading cause while in present study 13%patient had hypocellular marrow. 19,20 This variation could be due to local food preferences, poverty, prevalence of infections, geographical location, climate season. Various causes cited in different studies is presented below in a tabulated form.…”

Clinico-hematological study of pancytopenia: A single-center experience from north Himalayan region of India

“…However, the causes of pancytopenia show a wide variation throughout the world, and there is a need for local knowledge of the causes of this condition. [12345678910] The studies of pancytopenia from Uttarakhand, a north Himalayan state of India, are limited. In addition to clinical importance, the studies from this region may also vary from the rest of India due to geographical variation and, thus, may have epidemiological importance.…”